氯吡格雷在高龄冠心病患者介入术后长期应用及安全性研究

THE EFFECT AND SAFETY OF LONG-TERM USE OF CLOPIDOGREL IN TREATING CORONARY HEART DISEASE IN ELDERLY PATIENTS AFTER PERCUTANEOUS CORONARY INTERVENTION

目的探讨高龄冠状动脉粥样硬化性心脏病(冠心病)患者介入术后长期应用氯吡格雷的疗效及安全性。方法选择2007年9月—2010年2月经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗的高龄冠心病患者(≥60岁)76例,随机分为观察组和对照组,每组38例。2组PCI术后均常规口服阿司匹林和氯吡格雷6个月,之后观察组继续服用2种药物,而对照组仅服用阿司匹林,治疗6个月。PCI术后随访12个月,主要观察不良心脏事件、支架内血栓及出血情况。结果 2组患者PCI术后均随访12个月,随访期间观察组患者主要心脏不良事件发生率和支架内血栓发生率均明显低于对照组(P<0.05)。2组出血总发生率比较,差异无统计学意义(P>0.05)。结论对高龄患者PCI术后长期应用氯吡格雷,能减少PCI术后心血管不良事件发生的风险,且不会增加出血的危险。

Objective To investigate the effect and safety of long - term use of the clopidogrel in treating coronary heart disease （CHD） in elderly patients after percutaneous coronary intervention （PCI）. Methods Seventy- six elderly patients with CHD treated by PCI were divided randomly into observation group （38 cases） and control group （38 cases）. Observation group received aspirin and clopidogrel for 6 months, and control group only received aspirin for 6 months. The incidence of recurrent cardiovascular event,in - stent restenosis and hemorrhage between the two groups were compared after 12 - month follow - up. Results The incidence of recurrent cardiovascular event and in - stent restenosis were lower than that of control group （ P 〈 0.05 ） after 12 - month follow - up. There was no significant difference in the rate of hemorrhage between the two groups （P 〉 0. 05 ）. Conclusion The treatment of clopidogrel for long - term employed in elderly patients undergoing PCI can reduce the occurrence of cardiovascular events after PCI without increasing the bleeding risk.